(1096) Utilizing Simulation to Improve Pediatric Critical Care Fellow Comfort With Transport Consults

Introduction: At many training institutions, PICU fellows are required to consult via telemedicine to guide outside hospital management and inter-transport care. There is no published standardized training to provide these skills. This project aims to utilize simulation to train PICU fellows in professional phone communication, pertinent information gathering, triaging and managing some of the most common calls, and providing recommendations to ensure a safe transport.

Methods: We developed a simulation curriculum to be given as a portion of our standard academic curriculum. The primary target audience was pediatric intensive care fellows. For PGY-4 fellows, transport medicine lectures were presented by qualified personnel prior to simulation. The learners underwent three to six simulations based on academic year. Prior to and upon completing the simulations, learners completed a comfort self-assessment survey with comfort rated from 0 (not at all) to 5 (very comfortable). The simulations were deployed and evaluated by PICU faculty, who completed a competency survey that was used to provide targeted feedback to learners.

Results: We compared mean comfort level survey responses for all scenarios. The PGY-4 data had the most notable increase in mean scores in all simulation scenarios and overall comfort level increasing from a mean of 1.5 to 3. There were small increases in PGY-6 data, most notable in cardiac and trauma scenarios, and no changes in PGY-5 data.

Conclusions: Medical transport can often be overlooked due to focus on didactic time and bedside care. However, most PICU trainees are expected to act in a medical control role and advise outside hospitals and transport teams on safe clinical care. The results of this pilot study showed a significant increase in PGY-4 comfort in all simulations. There were small gains in PGY-6 data and these trainees vocalized that this curriculum helped “reinforce [their] skills.” This study was limited by participant numbers, however we are still in the data collection phase. Despite this limitation, we feel that the significance of the change in survey responses, especially in early-level trainees shows positive data and will continue to be clinically significant for all levels of training.